Jiefei Xiao, Lu Cao, Han Shi, Yongxu Shi, Shaoyan Mo, Kai Qin, Yonghua Li, Yanling Zhu, Yumei Jiang, Jian Rong
Department of Extracorporeal Circulation, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
NHC Key Laboratory of Assisted Circulation and Vascular Diseases, Sun Yat-sen University, Guangzhou, China.
Front Cardiovasc Med. 2025 Mar 11;12:1512619. doi: 10.3389/fcvm.2025.1512619. eCollection 2025.
Sepsis is a major cause of ICU admission and mortality in patients with infective endocarditis patients. This study aimed to explore the effect of intraoperative HA380 blood adsorption on surgical outcomes in infective endocarditis patients, given its ability to adsorb inflammatory factors.
We retrospectively analyzed the clinical data of patients who underwent surgical treatment for infective endocarditis at our hospital. After propensity score matching, eligible patients were matched in a 1:1 ratio between HA380 users and non-users. The primary endpoint was the incidence of postoperative sepsis, while secondary outcomes included ICU stay, postoperative hospital stay, and the need for CRRT, IABP, and ECMO therapies. Laboratory results were compared at 24, 48, and 72 h postoperatively.
A total of 148 patients were included in the analysis. After 1:1 matching, 39 pairs were further analyzed. There was no significant difference in the incidence of postoperative sepsis (20.5% vs. 15.4%, = 0.724). However, HA380 patients had a significantly shorter postoperative hospital stay (21.2 vs. 28.1 days, = 0.014), with no differences observed in the use of CRRT, IABP, or ECMO. Laboratory results showed that HA380 patients had significantly lower fibrinogen levels and a higher albumin-to-fibrinogen ratio.
This study did not demonstrate a reduced risk of postoperative sepsis with HA380 blood adsorption. Although the HA380 group had a shorter postoperative hospital stay, lower fibrinogen levels, and a higher albumin-to-fibrinogen ratio, the overall effectiveness of HA380 requires further investigation.
脓毒症是感染性心内膜炎患者入住重症监护病房（ICU）及死亡的主要原因。鉴于术中HA380血液吸附具有吸附炎症因子的能力，本研究旨在探讨其对感染性心内膜炎患者手术结局的影响。
我们回顾性分析了在我院接受感染性心内膜炎手术治疗患者的临床资料。经过倾向评分匹配后，符合条件的患者按1:1比例在使用HA380和未使用HA380的患者之间进行匹配。主要终点是术后脓毒症的发生率，次要结局包括ICU住院时间、术后住院时间以及是否需要连续性肾脏替代治疗（CRRT）、主动脉内球囊反搏（IABP）和体外膜肺氧合（ECMO）治疗。术后24、48和72小时比较实验室检查结果。
共有148例患者纳入分析。1:1匹配后，进一步分析了39对患者。术后脓毒症的发生率无显著差异（20.5%对15.4%，P = 0.724）。然而，使用HA380的患者术后住院时间显著缩短（21.2天对28.1天，P = 0.014），在使用CRRT、IABP或ECMO方面未观察到差异。实验室检查结果显示，使用HA380的患者纤维蛋白原水平显著降低，白蛋白与纤维蛋白原比值更高。
本研究未证明HA380血液吸附可降低术后脓毒症风险。尽管HA380组术后住院时间较短、纤维蛋白原水平较低且白蛋白与纤维蛋白原比值较高，但HA380的总体有效性仍需进一步研究。
